长期护理保险财务“质态均衡”探析

Analysis on the “Quality Balance” of Long-term Nursing Insurance Finance

截至2018年元旦,全国15个试点城市的长期护理保险试点政策均已落地实施。然而,国内长期护理保险在制度试点、学术研究领域均呈现"神散形乱"的局面,对财务平衡的研究更是存在对本质理念把握不足的问题。财务平衡影响要素分析发现,覆盖人群、评估标准、保障待遇三个因素对长期护理保险的财务运行具有"牵一发而动全身"的作用。将覆盖群体设定为16岁以上参加基本医疗保险人群,构建生理性指标与社会性指标兼具的综合性评价指标,保障标准延伸至生活照料、医疗护理领域,实现80%的保障纵深并配合以统筹层次的提升,从质态上保证长期护理保险制度的财务平衡。

Till the New Year's Day in 2018,the pilot policies for long-term care insurance in 15 pilot cities across the country have been implemented. However,the domestic long-term care insurance has presented a situation of “distraction” in the pilot and academic research fields. The study of financial balance has the problem of insufficient grasp of the essential concepts. The analysis of the factors affecting financial balance found that the coverage,evaluation criteria,and guarantee treatment have the major effects on the financial operation of long-term care insurance. We should set the coverage group to be more than 16 years old to participate in the basic medical insurance population,build a comprehensive evaluation index combining physiological indicators and social indicators,and extend the protection standard to the field of life care and medical care,achieving 80% of the protection depth and cooperation to achieve the financial balance of the long-term care insurance system from the qualitative aspect.